Hip replacement

[Jelena]

My husband is six months post transplant and all results are great, creatanine between 1.0 and 1.2 at all times. In the last couple of months he felt pain in his groin and hip, and thought he pulled some muscles because he started exercising. After the pain got worse, we went to an orthopedist. His right hip (that is the side where his new kidney is) is damaged and according to physician assistant who saw him yesterday, will have to have surgery. Right hip looks good on X-Ray, but she scheduled MRI for next week to make sure there is no damage there as well. We are both bummed. And scared.

I assume four years of dialysis, plus steroids post transplant did their job. But I have to say that he was reduced to a minimum dosage of steroids within two months post transplant and has been on 5 mg since.

I am really worried. Has anyone had hip replacement after the transplant and how did it go?

[rsudock]

Hello Jelena,
 My brother had a hip replacement when he was less then 25 years old.  When he had his transplant he was "pulsed" with high doses of steroids b/c he was having acute rejection episodes....they think that is what did his hip in....I had to drag him to the hospital b/c the GP doc kept saying "oh your fine, just need cortisone shot" and by that time he was dragging his one leg and could barely get in and out of a car....thank goodness it turned out alright....he is fine now, surgery went great!!!

I am not sure what the link is to the length of steroid use is and deterioration of the hip joints, but I had my first transplant for 10 years and was on dialysis for 11 months, and now I am on my 2ND transplant and have not had any problems with my bones/joints...(knock on wood)...

If you have specific questions please post and I will ask Neil for you!

[Jelena]

Oh, Rsudock, thank you so much for your post, it gave me some encouragement. I am so glad it all went well for your brother, and that you do not have these issues. I can only hope now that the damage on my husband's bone is not too bad and hopefully limited to this one hip only.  How long ago was your brother's hip replacement? Did he have any issues with kidney function during or after the surgery?
Thank you again so very, very much!

[rsudock]

Hey J sorry I haven't been around this week but here I am!!     Anyway Neil's hip replacement was Fall of 2008. At the time of his hip replacement Neil's transplanted kidney function was poor, but decent enough to keep him off the machine. A few months later he was back on dialysis.

Both of us started dialysis after having a major surgery. My nurse told me once, "no the anesthesia has no effect of your kidney function" but after I got my spleen taken out a week later (maybe less) I was on the machine for the first time.  The kidney was slowly starting to stop working.

I would think if his function has been pretty stable and good you should be in the clear, if the function has been slowly declining may not be great news....

Thinking about you and the hubs! Hang in there the best you can!!!

xo,
R

[coravh]

I haven't had a hip replacement but have had several surgeries after my transplant. I had stomach issues due to the sedation (I always do) but my kidney came through all the trauma just fine. I've had a pancreas transplant, a femoral bypass and a feeding tube inserted. Significant procedures and everything, including the healing, went well.

Cora

[lola]

Otto started to have problems within a few months of his transplant and had both hipd replaced less then a year after. Otto was only 23, 2nd set of hips put in 10 years later. I don't want to scare you but want to share that after the 2nd set Otto almost lost his kidney due to the pillow they used to keep him on his side during surgery, it put to much pressure on the kidney and it went to sleep for almost 3 months.

[Jelena]

Thank you all for your comments! Just to update: we've seen the orthopedist yesterday and he says that they are now doing this surgery under partial anesthesia and outpatient! Unbelievable. I suppose that not going completely under anesthesia will make it easier on the kidney, right?

[Jelena]

You guys have all had a lot to deal with! No wonder people say that kidney patients have the most scars on their bodies... and always something to worry about.

So sorry to hear about failed kidneys Rsudock and Lola. It must have been so hard!

Question for Cora: the femoral bypass you had, is that the procedure done to bring back blood supply to the hip joint? I heard different opinions about this. Is it working out for you? (I certainly hope it is)

[coravh]

Jelena, the bypass was to improve the blood flow to my foot. It had nothing to do with the hip. I now have excellent flow and my toe (which developed a dead spot) is now healing. Sorry it doesn't relate to your hip issues.

Cora

[Jelena]

Thanks Cora, so happy it is working!!! Awesome 

[Dman73]

I had my first hip replacement 7 years after starting dialysis in 73. That was caused by a problem with my parathyroids which were removed in 78.

After my transplant in 87 I had 6 hip revisions done with the last one in 2011. During my transplant years (87-02) I was weaned off prednisone early to protect against future bone loss.

I have always felt that the hip problem was my greatest nemesis more-so than dialysis.

On the positive side I am grateful to the technology that has allowed me to walk normally pain free even though I miss running, tennis & karate.

[Sax-O-Trix]

Necrosis caused by steroids is a major concern for transplant patients.  I have hip pain almost two years post transplant - loads of steroids due to two bouts of acute rejection.  Hip replacement is not somewhere I want to go!